[Roentgenoradiologic diagnosis of hydronephrosis]

In order to improve the selection of patients for surgical treatment functional roentgenoradiological diagnostic methods: "diuretic" renography (RRG) and excretory urography (EU) were employed in a group of 126 patients with hydronephrosis, Stages I, II and III, after V. S. Karpenko's classification (1980). Computer-assisted qualitative and quantitative assessment of the results obtained was performed with their further comparison with the results of routine RRG and EU. Regular changes in RRG and EU indices in the presence of diuretic load were shown for each stage of disease, and significant differences were revealed. The authors discussed morphofunctional changes and pathophysiological mechanisms laying the basis of reactions of the cavitary kidney system (CKS) to forced urination and reflected in indices of "diuretic" RRG and EU. A high differential-diagnostic value of the above methods in hydronephrosis was confirmed. Their use made it possible to specify indications for reconstructive operations, especially in controversial cases of the functional obstruction of the ureteropelvic segment. After diuretic RRG and EU one could refrain from surgery in 28% of the patients with obligatory follow-up.